MEDICARE: KATIE TOBISKA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1992968713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE TOBISKA

Provider Business Mailing Address
First Line	:	321 SAN FELIPE RD STE 14
Second Line	:
City	:	HOLLISTER
State	:	CA
Zip	:	95023-3035
Country	:	US
Telephone Number	:	831-245-8968
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 SAN FELIPE RD STE 14
Second Line	:
City	:	HOLLISTER
State	:	CA
Zip	:	95023-3035
Country	:	US
Telephone Number	:	831-245-8968
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2008
Last Update Date	:	12/06/2019

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Directions to “ KATIE TOBISKA ” Practice Location

Language	Start Address	Practice Location

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